Had ultrasound today Charlie did an excellent job they did not have to sedate him for the test
Findings are as follows:
Liver is of normal size shape and echogenicity
Liver margins are smooth and well defined
Gallbladder was distended and had sludge due to npo for testing
Common bile duct was not identified and the pancreas was within normal limits
Portal vein and vena cava are similar in size with strong blood flow
A portacaval shunt was not identified
Spleen is within normal limits
Both kidneys are normal in size and shape
There are numerous small1-2mm calculi shadowing within the diverticula in each kidney
There is no evidence of renal pelvic or ureteral dilation
Urinary bladder is within normal limits with a smooth mucosal surface and normal bladder wall thickness
The bladder is distended and contains urine
Prostate gland is normal in size and shape with uniform echotexture there is no evidence of sublumbar lymph nodes
Both adrenal glands were normal in size shape and echogenicity the left adrenal gland measues 4.6mm and the right 4.5mm in thickness
The gastrointestinal tract was normal in wall thickness and wall layering. There is no evidence of abdominal lymph nodes or peritoneal effusion
Diagnosis:
Mild bilateral chronic renal disease and kidney stones
No sonographic evidence of a portosystemic shunt
What does this mean for Charlie????
well it means we keep the diet changed to very low protein and stay on the new meds if there is a shunt it is very small as it is not effecting the blood flow through the liver but because he has the kidney stones he will stay on the lactulose to help keep the ammonia level down this is hard for the liver to filter. No surgery.... the only surgery they talked with me about would be an exploratory surgery and they did not feel that this was in Charlies best interest.
We will go every 3-4 months to have an ultrasound done to evaluate the kidney stones and repeat labs every 6-12 months
So all in all a good report
